Configuration Specialist

Position Title:  Configuration Specialist

Reports To:   BPaaS IT/Ops Support Manager/Director

Position Summary:   The Configuration Specialist will be responsible for creating and maintaining a variety of system configuration to ensure compliance with client and regulator business rules.  This requires the ability to work closely with internal and external stakeholders to interpret business requirements, design solutions and complete changes within the system.  The role also requires coordinating with industry third party software to ensure all rules are functioning appropriately to achieve desired results. In this role, the specialist must have excellent problem-solving skills, along with keen attention to detail and outstanding written and oral communication abilities.

Responsibilities:

• Review and translate business requirements into configurable components
• Design solution that drive highest levels of automated and accurate outcomes
• Develop, maintain and execute configuration changes including but not limited to benefits, pricing, member products/plans, premium billing, letters, other business rules and workflow
• Work with testers, operations and the client to ensure results match requirements
• Continuous validation of configuration environment to validate synchronization with current releases and coordinate environment updates as needed
• Document configuration changes, provide support in troubleshooting issues, track progress of completion and deployment of changes within expected timelines

Minimum Requirements

Industry Experience

3-5 years in healthcare industry experience working in the payer segment in Medicare Advantage, Managed Medicaid, or working with other healthcare service providers. Experience in setting up and maintaining healthcare payor system configuration is required. Experience in commercial lines of business is a plus.

Skills & Knowledge

Candidate must have knowledge of Medicare rules and the ability to translate into business outcomes.  Strong SQL experience, MS Excel, MS Access. Exceptional interpersonal, listening, written and oral communication abilities a must.  Attention to detail and the ability to work under time constraints are also required. Experience with Healthcare EDI files and knowledge of Medicaid rules are a plus.

Years of Experience

3-5 years

Education

A Bachelors of Science (BS), Bachelors of Arts degree (BA) or equivalent is preferred

Certifications/Licenses

N/A

Travel Requirements

N/A

References

Two Former Employers (Direct Manager)

Number of Implementations

N/A

Compensation

Competitive salary and benefits